So this Lil' Ole Blog was nominated for RESOLVE'S Hope Award for best blog! It was nominated last year but didn't win. Now we've got One More Shot (pun intended, that's the name of the documentary Noah and I have been working on)! So if you have a moment, please click here to vote.
Now that that's out of the way...
I wrote a more formal piece I thought I'd share. If you're new to this blog, welcome, this sums up our "journey to parenthood" in a (kind of long) nutshell. If you've been following for a while, thank you, and perhaps reading this written out can give a little hope/perspective/reminder that miracles do happen.
Here goes...
When my husband, Noah, and I set out to make a family in 2010, just after I turned 30, we assumed it would be a straightforward process involving just the two of us, and maybe a decent bottle of wine. We’d been together for ten years at that point, married for two, and fairly settled in our careers, the next natural next step was a baby.
So we started “trying.” It was fun at first, until “trying” turned into “failing,” which quickly turned into “obsessing.” I bought books and ovulation test strips, and a basal body thermometer. I made Noah keep all electronics far away from his private parts and forbade hot tubs and tight boxer briefs. I meditated, checked my cervical mucous, and stood on my head after we did the deed. And each month when it proved ineffective, I cried.
We spent a about a year doing this dance. When I talked to my OBGYN about our difficulties, he assured me I was young and needed to “just relax,” the worst two words a baby-crazed woman who can’t get pregnant wants to hear. He told me I was normal based on nothing but my history of good health. So we spent another six months or so “trying” and “failing” and then my OBGYN prescribed Clomid, the fertility gateway drug used to super-boost ovulation and increase the chance of conception.
Clomid did nothing but turn me into a raging lunatic for a month, and it was then that we decided we needed more help. After a year of trying unsuccessfully, we were officially deemed infertile by definition. So we went to see an infertility doctor, a reproductive endocrinologist, at a fancy office in Beverly Hills.
Dr. N knew how to deal with women like me--frustrated, confused, anxious, slightly crazed. Noah sat in the consultation completely silent as I showed Dr. N my monthly ovulation charts and some basic hormone tests I had done, as well as Noah’s semen analysis. All our preliminary test results looked fine, but there were a lot more tests to do. None of them were covered by insurance, and none of them were cheap. Though Dr. N was hopeful for us, I was considerably young in the infertility world and we seemingly had healthy sperm and a functional uterus. The next few months became a time of figuring out what we had and what we needed to make a baby.
I had a hysterosalpingogram (HSG) done, in which ink was inserted into my uterus and Fallopian tubes to see if the tubes were open. That test revealed some concerns about my tubes which were later confirmed in a laparoscopic surgery, which were later disproved by another HSG that showed two open functioning Fallopian tubes. One problem with these types of imaging tests is that they aren’t always consistent, since the body changes. We will never really know if there was an issue with my tubes, but we found that wasn’t the main problem anyway. After some blood tests and ultrasound evaluations, I was diagnosed with Diminished Ovarian Reserve (DOR). That meant my egg reserve was low and my ovarian functioning was compromised.
DOR is one of the more challenging infertility diagnosis, as the success of conception through infertility treatments depends on having that one good egg. While part of me was relieved to have solved the mystery of our conception challenge, another part of me knew this was not good. DOR is not a very common diagnosis for women in their early 30’s, but it is seen more often. According to the American Society for Reproductive Medicine, “about one-third of infertility cases can be attributed to male factors, and about one-third to factors that affect women. For the remaining one-third of infertile couples, infertility is caused by a combination of problems in both partners or, in about 20 percent of cases, is unexplained.”
Our best chance seemed to be in-vitro fertilization (IVF), in which my ovaries would be medically stimulated to produce as many follicles containing eggs as possible, which would then be extracted and combined with Noah’s sperm and implanted back into my uterus. The process would take about 2-3 weeks and would cost about $10,000, plus medication, which would be about another $5,000. Once the decision to do IVF was made, I started preparing my body. I changed my diet and saw an acupuncturist for weekly treatments, including herbs, with the hope of increasing my low follicle count. After a handful of frustrating setbacks and several months of acupuncture, my follicle count increased by 1/3 and we were ready to begin medication. For ten days Noah injected a cocktail of hormones into me several times a day. It was a nightmare. We essentially had to board up the windows and lock the doors to wait for the emotional tornado to pass. The day of our aspiration, the procedure where the eggs are removed from my body, Dr. N retrieved five good quality eggs, three of which fertilized beautifully the next day. The day we got the call that three had fertilized was one of the high moments of our fertility journey. Noah and I felt our babies were coming, and we debated how many embryos to put back in. The implantation of multiple embryos is what often accounts for the increased number of multiple births with IVF. We decided we would put in two, be fine with twins, and have one left over to freeze for a frozen embryo transfer (FET) at a later date.
But with the highs also come the crashing lows. The following day the doctor called to let us know that the three fertilized eggs were not dividing properly, meaning they were not becoming embryos. He proceeded to monitor them for the rest of the week, giving us daily updates on the slightly shifting status, but the prognosis didn’t look good. Finally, after about a week in limbo, we were told there was nothing to transfer back into my uterus. All that effort washed down the drain.
I knew this was a possibility, but I didn’t believe it. How could we spend upwards of $15,000, inject so much medication into my body, and go through the emotional roller coaster of hope and despair, only to have nothing to put back in? I didn’t even have the chance to be pregnant. The doctor told us our chances were slim because of my ovarian issues. He told me I might not respond well to the medication, and that there was a chance of having nothing to transfer back in. He also told us all we needed was one good egg. He was right on all accounts.
For people who are ambivalent about having kids, this whole process may seem insane. Actually, much of it is insane, but for a gal like me who has always dreamed of being a mother, who taught preschool and first grade and then became a psychotherapist primarily working with kids, not having a family was just not an option for me. Adoption was a possibility, but I really wanted to experience pregnancy and birth, and Noah preferred trying for a genetic child, so we planned to first do what we could to get pregnant, and then we would reassess.
When we first entered the elite world of assisted reproduction, we knew nothing about it and knew no one who had experienced infertility. But the more open we were with our own difficulties, the more people we met who also struggled. People were writing into my blog from all over the world, sharing stories of how certain family building options, like surrogacy or egg donation, are illegal, and how different laws in different countries prohibit single women from accessing treatment. There are 7.3 million people in the U.S. who are struggling with infertility, and millions more around the world, yet how was it something we never heard much about? We learned that although infertility is a medical condition, there is a lot of shame associated with it, and it’s often a diagnosis not covered by insurance.
The months following our first unsuccessful IVF cycle were brutal. We’d come up empty handed and didn’t know what to do next. We met with Dr. N for a follow-up meeting and he said something like, “If you had won the lottery and IVF wasn’t as emotionally and physically exhausting as it was, I would recommend doing another round.” IVF is often most successful after several tries. But knowing our financial situation and the outcome odds of using my eggs, he recommended donor eggs.
I wasn’t yet ready to have the donor egg talk. A proven anonymous egg donor can cost upwards of $30,000. It also meant carrying a child that was not genetically related to me. We still weren’t sure if I could even get pregnant, and I wondered if there was actually a problem with the ability of my uterus to carry. It would be an expensive and time consuming endeavor to go through a cycle with an egg donor only to find out I couldn’t carry a baby to term.
Noah and I began investigating adoption. We had heard the comment, “Why don’t you just adopt?” from many people during our pursuit of parenthood, as if there were a baby store where one could go and pick out a baby of their choosing. Adoption is a great choice for many, but it is also time consuming (it takes an average of 15 months), expensive (for us, at a non-profit adoption agency it would cost around $30,000), and contains its own risks. We were open to it, but it was not our first choice. We had started doing monthly medicated intrauterine inseminations (IUI), a cheaper yet less effective fertility treatment, when my younger sister offered to donate her eggs.
Though Dr. N warned us of the risks of using a donor who was genetically related to me and had never had children, all of my sister’s preliminary test results came out good. She had eggs and her hormone levels were good. Noah would have a chance at a child genetically related to him and I would have a chance to carry our baby, which would also be closely related to me. And it would be about $10,000 less than an anonymous donor. This seemed like the best choice for us, and so I started applying for grants that might help fund this endeavor and we began to plan for a time my sister could move back home for two weeks so her eggs could be harvested.
We ended up getting a grant from the Baby Quest Foundation that covered about half of the medical procedure and helped with the cost of medication. My parents offered to help us financially, my sister, of course, was helping us physically, and I continued to see Gilli, my acupuncturist, who now not only treated me, but also my sister, in preparation for our donor egg cycle. Suddenly our baby-making efforts became a family and extended-family affair.
I’ll spare the details of the egg donor cycle; I will say it didn’t work. While we did get to our first transfer day, none of the three embryos we implanted took. Neither did the single frozen embryo transfer we did the following month.
Noah and I were both shocked and devastated. We were emotionally, physically and financially depleted. By this point, we had spent the better part of three years trying to make a family, and all we had to show for our efforts were credit card bills and a few extra pounds around my waist.
Infertility impacts all areas of your life as you become addicted to the hope of one day being able to have a baby. Once you’ve started treatments, it’s hard to walk away—you’ve invested so much into the process, and are lured to stay the course by the carrot of success that dangles in front of you. According to the European Society of Human Reproduction and Embryology (ESHRE), an estimated five million babies have been born as a result of Assisted Reproductive Technology (ART) since 1978, when the first baby was born through IVF. Data collected by the International Committee for Monitoring Assisted Reproductive Technologies estimated that, “around 1.5 million ART cycles are now performed globally each year producing around 350,000 babies.”
After my sister’s egg donor cycle proved unfruitful for us, Noah and I went back to the drawing board. We tried naturally for six months while we began to readjust our goals. Our goal was no longer just getting pregnant; it was becoming parents and getting out of the exhausting lifestyle of a couple going through infertility. A recent online article from US News and World Report cited a Danish study that found infertile couples who fail at treatment were three times more likely to get divorced. Psychological impact surveys have shown women with infertility experience anxiety and depression similar to those diagnosed with cancer and other major illnesses. Noah and I knew living like this for much longer was not going to be good for anyone. So we weighed our various options, the cost of said options, and the time commitment of each, and landed upon our next baby making endeavor: embryo donation.
Embryo donation is essentially when the remaining frozen embryos from a couple’s IVF cycle are donated to another couple. Often couples have left over embryos they pay to keep in storage. There are approximately a half a million embryos cryopreserved in the U.S. Once a couple has successfully completed their family, they have choices as to what they want to do with their embryos. The least common choice, is to donate them for another couple’s use. Needless to say, finding a donated embryo is not the easiest process, but nothing in the world of infertility is. I set out to find an embryo match for us, and within a few months, I found a set of two embryos in another state. They had been created by an egg donor and the husband of the infertile couple who had donated the embryos, and they happened to be my ethnic mix. Something felt right.
In July 2014, we did a frozen embryo transfer and lo and behold it worked. We made it through a touch-and-go pregnancy and a slightly traumatic birth, and now have the most amazing 4 month-old we could ever imagine. She is 100% the baby that was meant to be ours.
Sometimes life throws you a curveball, and you have no choice but to swing for the fences. We struck out many times before we finally hit a home run. We had to learn how to make the best decision with what we had in front of us. We had to learn how to be patient and persistent, hopeful yet realistic. We had to learn how to re-conceptualize the idea of what makes a family. And after many years, we finally made it to the other side. It just took a bit more than a decent bottle of wine and one magical night. And would I do it all over again to end up with the baby girl we have? Absolutely.